How much rates vary
Facilitymedian $724 · 10th to 90th $123 to $3,631Professionalmedian $372 · 10th to 90th $214 to $1,413
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,318.26 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,238.72 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | None | $213.80 | $213.80 | $223.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
AllWays Health Partners Setting Professional Modifier None Typical Low $239.88 Median $501.19 Typical High $1,412.54 | Professional | None | $239.88 | $501.19 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Facility | None | $676.08 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $645.65 | Professional | None | $295.12 | $295.12 | $645.65 |
Fallon Health Setting Facility Modifier None Typical Low $69.18 Median $309.03 Typical High $5,888.44 | Facility | None | $69.18 | $309.03 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | None | $263.03 | $263.03 | $309.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $602.56 | Professional | None | $234.42 | $416.87 | $602.56 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $537.03 Typical High $2,818.38 | Facility | None | $87.10 | $537.03 | $2,818.38 |
Mass General Brigham Setting Professional Modifier None Typical Low $239.88 Median $501.19 Typical High $1,412.54 | Professional | None | $239.88 | $501.19 | $1,412.54 |
United Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $2,818.38 | Facility | None | $117.49 | $537.03 | $2,818.38 |
United Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $602.56 | Professional | None | $199.53 | $338.84 | $602.56 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,511.89 | $3,630.78 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | 52 · Reduced service | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $22.39 |
Where Massachusetts sits
The same service costs 7.2 times more in Oklahoma than in Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 9th of 51
$407
OK $1,000VA $138
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.